Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | MD-2392 | HI |
NPI | 1295887685 |
---|---|
Provider Name | Dr. Marco Rizzo |
First Address | Honolulu, HI 96813-2429 |
Second Address | Honolulu, HI 96813-2429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3850-5 | HMSA PROVIDER ID NUMBER (01) | HI |
D43616 | (02) | HI |
MD-2393 | STATE MD LICENSE # (01) | HI |